Hyde Park Convalescent Hospital, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

910000066 Issued in CA

Legal business name

HYDE PARK CONVALESCENT HOSPITAL, INC.

Practice address

6520 West Blvd
Los Angeles, CA 90043-4311

Phone

(323) 753-1354

Fax

(323) 753-0509

NPI assigned

Dec 8, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Elaine M Wiesel

Title

Administrator

Phone

(323) 753-1354

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• HYDE PARK CONVALESCENT HOSPITAL Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433721600000",
    "number": "1689733453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 WEST BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900434311",
            "telephone_number": "323-753-1354",
            "fax_number": "323-753-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 WEST BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900434311",
            "telephone_number": "323-753-1354",
            "fax_number": "323-753-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYDE PARK CONVALESCENT HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-08",
        "last_updated": "2015-06-08",
        "status": "A",
        "authorized_official_last_name": "WIESEL",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "323-753-1354",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "910000066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZT05326G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HYDE PARK CONVALESCENT HOSPITAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• John Hy, PSY.D.
• Lien Hy, PMHNP-BC
• Jessica Hyatt, AMFT, APCC
• Joel D. Hyatt, MD
• Stephanie Hydal
• Hyde Park Rehabilitation Center LLC
• Christen A Hyde-Treuhaft, NP
• Kyrie Hyde
• Manly R. Hyde, MD
• Tre' Jor La'Nae Hyde

• Skilled Nursing Facility in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.